An Initiative Technique to Facilitate Axillary Vein Puncture During CRT Implantation.
An Initiative Technique to Facilitate Axillary Vein Puncture During CRT Implantation.
复制标题
一种促进 CRT 植入期间腋静脉穿刺的主动技术。
DOI：
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复制
发表时间：
2015
期刊：
影响因子：
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通讯作者：
S. A. Al Ghamdi
中科院分区：
文献类型：
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作者：
A. Al Fagih;A. Ahmed;Y. A. Al Hebaishi;A. El Tayeb;K. Dagriri;S. A. Al Ghamdi
目标
OBJECTIVES
The aim of the study was to describe a new technique to minimize requirement of contrast and the time to puncture the axillary vein during implantation of cardiac resynchronization therapy (CRT) devices.
BACKGROUND
One of the challenges to the wide applications of CRT has been the technical difficulty encountered while obtaining venous access utilizing axillary venous puncture. This is mainly due to vague anatomical land marks. The axillary vein is the preferred access point because of fewer associated risks and better lead protection in the future.
METHODS
We introduced a 0.035 mm guidewire retrogradely from the femoral vein up to the left axillary vein. A single anteroposterior scene at 7.5 frames/second was captured while the guidewire was in the vein. The scene was kept as a roadmap for the axillary vein puncture during the implantation procedure.
RESULTS
The axillary vein was accessed in all patients (100%) and the time to axillary vein puncture was <1 minute in 36 patients (41%) and between 1-5 minutes in the remaining patients. There were no related vascular complications and no contrast venography was required.
CONCLUSION
The use of retrograde axillary vein wiring simplifies axillary venous puncture and minimizes the need for contrast media during CRT device implantation without compromising visualized anatomy.